{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T02:56:17Z","timestamp":1777517777262,"version":"3.51.4"},"reference-count":69,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008567","name":"Leeds Beckett University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008567","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"abstract":"\n Abstract<\/jats:title>\n \n The characterization of skeletal muscle phenotypes in diving populations remains one of the least explored domains of breath\u2010hold physiology, representing a critical gap in our understanding of how skeletal muscle adapts to the unique demands of breath\u2010hold diving. Accordingly the present study investigated specific markers of skeletal muscle structure and metabolism in competitive breath\u2010hold divers. Twenty males volunteered to participate in this study (10 competitive breath\u2010hold divers; 10 non\u2010divers), matched for age, body size and whole\u2010body aerobic capacity (). A percutaneous skeletal muscle biopsy was obtained from the\n m. vastus lateralis<\/jats:italic>\n to quantify capillarization, fibre\u2010type distribution (i.e. types I, IIa and II other), protein content of mitochondrial complexes, monocarboxylate transporter (MCT) isoforms and citrate synthase activity. MCT4 content was 28% higher in breath\u2010hold divers compared to non\u2010divers (\n P<\/jats:italic>\n \u00a0=\u00a00.020), whereas MCT1 and citrate synthase activity showed no between\u2010group differences (\n P<\/jats:italic>\n \u2265 0.161). Complex V content was higher in the non\u2010divers (\n P<\/jats:italic>\n \u00a0=\u00a00.049), whereas no between\u2010group differences were noted for complexes I, II, III and IV (\n P<\/jats:italic>\n \u2265 0.253). Capillarization was significantly higher in breath\u2010hold divers (\n P<\/jats:italic>\n \u2264 0.048), whereas fibre\u2010type distribution did not differ between groups (\n P<\/jats:italic>\n \u00a0=\u00a00.999). Competitive breath\u2010hold divers exhibited skeletal muscle characteristics indicative of enhanced blood\u2013muscle exchange capacity and augmented lactate efflux potential. Such adaptations may confer an advantage during prolonged breath\u2010holds by preserving glycolytic function and maintaining redox homeostasis. In recovery these traits likely facilitate more efficient clearance of metabolic byproducts.\n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>\n \n Key points<\/jats:title>\n \n \n \n The skeletal muscle phenotype of breath\u2010hold divers remains poorly characterized, limiting understanding of how skeletal muscle adapts to the physiological demands of prolonged breath\u2010holding.<\/jats:p>\n <\/jats:list-item>\n \n This study compared skeletal muscle structure and metabolic markers between competitive breath\u2010hold divers and non\u2010diving controls matched for age, body size and whole\u2010body aerobic capacity.<\/jats:p>\n <\/jats:list-item>\n \n Breath\u2010hold divers exhibited greater skeletal muscle capillarization, indicating an enhanced capacity for blood\u2013muscle exchange.<\/jats:p>\n <\/jats:list-item>\n \n They also showed an increased potential to remove lactate from skeletal muscle tissue.<\/jats:p>\n <\/jats:list-item>\n \n These adaptations likely support sustained glycolytic function and redox balance during prolonged breath\u2010holds, while facilitating more efficient clearance of metabolic byproducts during recovery.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1113\/jp290732","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T17:55:21Z","timestamp":1775757321000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diving into the unknown: Evidence of enhanced skeletal muscle lactate efflux potential and blood\u2013muscle exchange in competitive breath\u2010hold divers"],"prefix":"10.1113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5991-0733","authenticated-orcid":false,"given":"Antonis","family":"Elia","sequence":"first","affiliation":[{"name":"Division of Environmental Physiology, Department of Physiology and Pharmacology Karolinska Institute Stockholm Sweden"},{"name":"Carnegie School of Sport Leeds Beckett University Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1422-0154","authenticated-orcid":false,"given":"Matthew","family":"Lees","sequence":"additional","affiliation":[{"name":"Exercise Metabolism Research Group, Department of Kinesiology McMaster University Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"O'Hara","sequence":"additional","affiliation":[{"name":"Carnegie School of Sport Leeds Beckett University Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Hodson","sequence":"additional","affiliation":[{"name":"Department of Sport and Exercise Science, Institute of Sport Manchester Metropolitan University Manchester UK"},{"name":"School of Sport, Exercise and Rehabilitation Sciences University of Birmingham Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9808-5519","authenticated-orcid":false,"given":"Jordan","family":"Acheson","sequence":"additional","affiliation":[{"name":"Department of Sport and Exercise Science, Institute of Sport Manchester Metropolitan University Manchester UK"},{"name":"School of Sport, Exercise and Rehabilitation Sciences University of Birmingham Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Wilson","sequence":"additional","affiliation":[{"name":"Carnegie School of Sport Leeds Beckett University Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3463-2669","authenticated-orcid":false,"given":"Paul","family":"Parker","sequence":"additional","affiliation":[{"name":"Royal Centre for Defence Medicine Birmingham 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